11 Fla. L. Weekly Supp. 781b

Insurance — Personal injury protection — Coverage — Fee-splitting — Patient brokering — Error to enter summary judgment where there is genuine issue of material fact as to whether physician who was paid a portion of billed fee by medical provider was employee of provider or independent contractor and whether arrangement between physician and provider violated statutes prohibiting fee-splitting and patient brokering

PROGRESSIVE EXPRESS INS. CO., Appellant, vs. MIAMI-DADE HEALTH & REHAB SERVICES, as Assignees of IDALIA CEDRES, Appellee. Circuit Court, 11th Judicial Circuit (Appellate) in and for Miami-Dade County. Case No. 02-585 AP. L.C. Case No. 01-2256 SP 24. July 13, 2004. On appeal from the County Court for Miami-Dade County, Jeffrey D. Swartz, Judge. Counsel: Douglas H. Stein, for Appellant. Marlene S. Reiss, for Appellee.

(Before ROSINEK, J. RODRIGUEZ, and MURPHY, JJ.)

(RODRIGUEZ, J.) The decision of the lower tribunal granting summary judgment to the Miami-Dade Health & Rehab Services (MDHRS) is reversed as to the issue of the reasonableness of the charges of Dr. Blinn for medical services rendered. There is a genuine issue of material fact as to whether Dr. Blinn’s medical bills were reasonable, necessary, and related to Idalia Cedres’ injuries. See Volusia County v. Aberdeen at Ormond Beach, L.P., 760 So. 2d 126, 130-31 (Fla. 2000).

Summary judgment is also reversed as to the issue of fee-splitting under §817.505, Fla. Stat. (2000). Appellant argues, and this Panel agrees, that there are genuine issues of material fact which should have precluded the entry of the summary judgment. According to the Appellant, there is a genuine issue of material fact as to whether the fee arrangement between the Appellee and Dr. Blinn violated §§ 817.505 and 458.331(i), Fla. Stat. (2000). Additionally, the final summary judgment found that Dr. Blinn was employed by MDHRS, but there was uncontroverted testimony in the various depositions that Dr. Blinn was a contract employee, or an independent contractor. MDHRS billed Progressive $400, while Dr. Blinn was paid $125 for his services. The lower court needs to make a factual and legal determination as to whether the arrangement between Dr. Blinn and MDHRS was in contravention of the applicable statutes.

REVERSED and REMANDED. (ROSINEK and MURPHY concur.)

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